CMS Rule Would Make States Track Medicaid Pay Systems
On Friday, CMS issued a proposed rule requiring states to evaluate their provider payment systems for fee-for-service Medicaid plans, in response to the U.S. Supreme Court's announcement that it would consider various conflicting federal court rulings about states' rights to cut reimbursements. The rule would require states to discern if their payment rates have created "access issues" by periodically monitoring beneficiaries' needs, the availability of care and the utilization of services. The rule also would prevent states from slashing Medicaid payments unless they could demonstrate that beneficiaries would have "sufficient access" to care following the cuts.
- "Rule Seeks To Address Conflicting Court Decisions on Medicaid Reimbursements" (Daly, Modern Healthcare, 4/29).
- "Rule Would Discourage States' Cutting Medicaid Payments to Providers" (Pear, New York Times, 5/2).